Provider Demographics
NPI:1093847253
Name:BOYCE, CASEY RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:RENEE
Last Name:BOYCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CASEY
Other - Middle Name:RENEE
Other - Last Name:BRADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:STE 160
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-2593
Mailing Address - Country:US
Mailing Address - Phone:513-424-1440
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 160
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-5200
Practice Address - Country:US
Practice Address - Phone:513-424-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086447207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000518633OtherANTHEM
OH2772861Medicaid
OHPO0419395OtherMEDICARE RAILROAD
OHBO4212211Medicare PIN